WebMD Medical News
Louise Chang, MD
Feb. 5, 2009 -- Genes play a role in your appearance as you get older, but
the real villains of the wrinkles of aging involve behavioral choices such as
smoking, eating, and sun exposure, a new study shows.
The study is published online in Plastic and Reconstructive Surgery,
the official medical journal of the American Society of Plastic Surgeons.
Environmental factors and personal lifestyle choices more than genes can add
years to a person's appearance, study researcher Bahman Guyuron, MD, chairman
of the department of plastic surgery at University
Hospitals, Case Medical Center in Cleveland, tells WebMD.
The study involved 186 pairs of identical twins. During the study,
researchers obtained comprehensive questionnaires and digital images from all
the twins. An independent panel reviewed the images and recorded perceived age
differences between the siblings.
Guyuron says the study suggests that non-genetic factors may be major
culprits for wrinkles, lines, and blotches. But anything that fills your life
with stress, such as a job you hate or too much debt, can also draw lines all
over your face later in life, he says.
"Identical twins, unless they behave exactly the same, will exhibit
their different lifetime experiences on their faces," he says. "If the
biological clock is designed to make you age in a certain way, you can alter
that by eliminating some of the external factors that make you age
Guyuron says these factors include smoking, alcohol consumption, and food
intake. Depression also can lead to lines
and wrinkles, even if people with that condition take antidepressants.
He tells WebMD that relaxation of facial muscles due to use of
antidepressants might be why more sagging was recorded in twins taking such medications. But it's not a
"might," he adds, that stress is "a common denominator" of
Richard Winer, MD, an Atlanta psychiatrist, says in his 24 years of
practice, he's noticed that people who take antidepressants soon look better
and develop fewer lines as they age.
"When people are depressed, there is a tendency not to take care of
yourself, and maybe to smoke and drink more," he tells WebMD.
"Generally speaking, when people are happier, they tend to look younger.
Colleagues have noticed the same thing."
Also, aging reduces hormones, and "if they are replaced judicially under
medical advice, that will delay aging," Guyuron says. "Estrogen has a
significant effect on the elasticity of the skin." To look younger, overweight people shouldn't try
to lose a lot of weight quickly, he says.
Seth A. Yellin, MD, chief of facial plastic surgery at Emory Healthcare in
Atlanta, says everyone loses "facial volume" with age and "gets a
loose neck. If we replenish facial volume, it can make an older face look more
Genetics, Yellin tells WebMD, "is only one component of aging. You have
a great deal of control over how you will look at 45, 55, or 65. If you eat
well, maintain a good body mass index, don't smoke,
wear sun protectant, and keep yourself fit, then you're going to look better
than your genetic identical twin who makes bad decisions, eats high-fat foods,
ignores admonitions about [too much] sun, and goes to a tanning bed."
Yellin says that after age 40, people with "higher than normal weight
are going to look younger because fat is going to stretch the skin,"
lessening the appearance of wrinkles, but no one should gain
weight to keep from looking old.
Researchers looked at identical twins because they are genetically
programmed to age in exactly the same way. But Guyuron says the study shows
"you can cheat your biological clock" by making smart choices, such as
"Some patients, particularly those who have eating disorders, feel they
will look younger if they lose a lot of weight after 40," he says. "But
actually that will make you look older."
He says he doesn't recommend that people in bad marriages stay together, but
faces of twins in the study suggested that those who'd divorced looked nearly
two years older than siblings who hadn't.
In twins younger than 40, the heavier ones were perceived as being older,
but in those over 40, the lighter ones looked older, says Guyuron.
"The research is important for two reasons," Guyuron says.
"First, we have discovered a number of new factors that contribute to
aging, and second, our findings put science behind the idea that volume
replacement rejuvenates the face."
SOURCES:News release, American Society of Plastic Surgeons.Guyuron, B. Plastic and Reconstructive Surgery, April 2009; vol
123.Bahman Guyuron, MD, University Hospitals, Case Western Reserve University,
Cleveland.Seth A. Yellin, MD, chief of facial plastic surgery, Emory Healthcare,
Atlanta.Richard Winer, MD, psychiatrist, Atlanta.
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